You Reap what you Incentivize.

In dentistry, we’ve been incentivizing intervention and volume. That’s because the fee for service reimbursement model rewards us when we cut, drill, excise and extract. And there has been no emphasis on quality or efficiency. We haven’t been incentivized to watch, to monitor, to prevent or to improve.

V-blog: “You Reap what you Incentivize.”

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8 thoughts on “You Reap what you Incentivize.

  1. I don’t think dentists are only drilling and filling. but you are right – the incentives are all wrong in the dental profession. not like medicine


  2. I am a dentist and I think that dentists are already laborers! we gloss over medical history and treat only teeth and gums. we don’t think about general health, smoking cessation and etc etc. I agree. good post.


  3. i agree. but suggest an alternative. fee for service works ok. only unethical dentists do bad things. just like there is unethical laqwyers, unethical doctors, unethical teachers. Can your proposed changes affect bad people? and stop this kind of behavior? do incentives even work? they don’t work on my childre. or worse, when i used to offer pocket money to do chores….they don’t care about chores they just focus on geetting the money. now, disappointed to say, they always look at “whats in it for me” when they are asked to do anything. They are only 5 and 7 and hope they will grow out of it. but incentivizing them was a mistake i think. but, i know dentists problem is more complciated than my kids…just saying.


    1. I think the dentists world is a bit more complex than your kids, champ. Dentists deal with insurance companies, enormous dental school debt, pressure from corporate operations adn threat from mid-level providers in some states. I tell my sons NOT to become dentists like me – the profession isn’t what it used to be.
      I do agree with Gary that fee for service isn’t all bad. And all dentists aren’t bad.


    2. Hello Gary,
      Thanks for your post! The good news is that incentives DO work. In fact, research shows that loss aversion is more powerful than bonuses and incentives. There is a controversial study about incentivizing kids through payments for reading books. Although extremely controversial (the researcher received several death threats during the year long experiments!) it showed that this incentive had a long term educational benefit for students! It is possible to incentivize kids with money!!

      Cash for reading:,9171,1978758,00.html
      Loss aversion > bonuses.


  4. i agree with this doctor and i agree with the comment by Toby Mark Woods. Dentists are already laborers! i am a dentist and i agree. few dentists will think about the diabetic status of a periodontal patient. few dentists will really delve into the diet history of a high caries risk patient. few dentists even do oral cancer screening. private practice is so busy and you end up doing a 5 second medical history and then start drilling. I agree with this post – there has to be a reimbursement for whole case management. for thinking about how diet affects disease etc etc. it’s not that dentists are bad, but you have to keep the business running and therefore you have to earn money. how do you earn money? Drill fill and bill. i like your post doctor. thank you


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